Time Off Requests

Time Off Requests

MM slash DD slash YYYY
Your Name(Required)
Please note that this is for FUTURE time off requests only. If you are calling out SICK, please email the CDD-Scheduler DG.
If schedule isn't made yet for the requested time off dates, put: "on call fellow/attending", if unsure of covering provider please list "TBD"
MM slash DD slash YYYY
MM slash DD slash YYYY
Please provide makeup session dates if you are cancelling a session within 30 days of when it is scheduled